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01183
PUTNAM ,00 'TY DEPARTMENT OF "HEALTH
x DT'sion of Envfronmenta/ Hea'lrh Services, Garmel N Y 16512
CERTIFICATE O.F;GUNSTRoC ION CONiPLIANCL FOR 'SEWAGE MSPOSAL SXSTEM "`• ,Town of Patter`sorr �
a y, t Towh or Village
,
[�
Located at Fa I,ry J 1 1`e` Road, Putre mLake',' P,atte_rot,on 55 Biock 5
Towne, Anthony J N i`.codemo I_ot 3` Job 1649
( ;
kR;�>lC�vexax�x8a>be��e: r } Address Brewste,r-., .'New York.
Separate' Sewerage System built by
���f Frank: Amendol a ;
Consisting df c+4 �! Gal. Septic Tank lineal Feet X widtfi'. trench
F ofo x 36' W4 de.1eaching fiel
166 1
Other requirements ?
Water Supply: Public Supply From `
y Savo�/ Brewster, New York
Private.S6pply.Dr�lled' By y a'
r Address
n 1 f 3m'i 1
_u, res I Bence.' =No Bedrooms 2`.
ld�ng Type y of
•
a, P.uRF/yr
\CPQ' �,^
Has Erosion Control Been Completed
1 certrfy ",that the systems) as listed serving the above premises ware constructed essentiall n th
la `of ha oRtY h t w� k ( pies of which are
attached) and�.in accortlance with the 'standards ;.,`rules and regulations plans Bled, a rm' sue
h he Au nam. t�; DYe rtment of Health.
Y
fi
310 Jane : 1 9 7 6, zt
� R
:Date Certified b..
i e*', em Park Plar KAY naW N
' k Address
•,y •Q No a �� 8129
rHHeT ;AFB
Any person occupying p erhiiei•served by the above systems) shall prom lyitake'such action as may be tsar •� rrection of any.unsanitary.
conditions resulting from.: such usage: Approval of'the" separate sewerage-'s- shall`becgme: null an t#'as soon s 'a;public sanitary sewer ,becomes
'available and the approval of. the private water supply shall become null and void' =when a' public 'water supply becomes available: Such approvals are
subject to modif�cat�ori or change when, I` ,the: judgment of the issioner of H th' such cation modification or change is necessary.
T.t
Date Pe_sr �n �ar�E. - ::Y B 5 S x, 11a+ oR ,n
v '
,�. , �Q_. ; a'rk�c.,'�IJ `t'— ..+- .`'� 4 .v:sr s,bre*..r•t r.N?f;:
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J
YORMTWN MEDICAL LA9.0RATORY Of
`Ybihtown Heights, W P.00 Box. 99-- 321., Keav Streef.
.-Y. 10598
DATE COLLECI
RIESU.LtS OF EXAMINATION OF WATER
OWNER DATE RECEIVE]
ANTHONY hrr r, A
CITY, VILLAGE, TOWN VOR NAMPE OF SUPPLY DATE REPORTED
4 nuRviLLE-, RD. PATTERSON, -N.Y.
5AMPLING POINT
TAP
BACT8RIA PER ML. (Agar plate count at -350 C).
COLIFORM.-GROPP (Most ptobqble N6./l 00mi.)
LESS THAN 2 2
:HARDNESS, TOTAL -ppm'
DETERGENTS - ppm
NITRATES (as N) - ppm
IRON, TOTAL - ppm
7LOURIDE (F) - mg./I.
These re'sulis-indicqte that the water was. YES of a satisfa6tory sanitary qudlity when th loFs ed.
GOLDENS BRIDGE PHARM.
PER. );
7,4 �4n - . //) r
r
WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH
3/71 - - Division of Environmental Health Services
,m
COUNTY OFFICE BUILDING • CARMEL, NEW YORK.
This report is to be completed by well driller and Suhr. 4ted to County Health Department together with laboratory report of
analysis of water sample •indicating water-is of satisfactory bacterial quality before certificate of constriction cornpli`ance is issued.
REPORT MUST- -.BE SUBMITTED %NITHIN 30 DAYS"OF WELL COMPLETION
OWNER
NAME '
Jj ,
ADDRESS
��Y J• _,I
LOCATION
OF WELL
(No. 6 Street) . (Town) •,,, (Lot Number)
USE OF
WELL
PI
DOMESTIC' USINESS El
LJ DOMESTIC Cl ESTABLISHMENT FARM a TEST WELL
11 SUPPLY 0-INDUSTRIAL Li CONDITIONING . ((S Speciy )
DRILLING
EQUIPMENT
211RIOTARY
D COMPRESSED CABLE OTHER
AIR PERCUSSION L PERCUSSION D (Specify)
CASING.
DETAILS ,.
; J DIAMgTRfines) WEIGH PER FOO DR V 5 O LENGTH (eaf)
dam
THEADED LJ WELDED IJYES � NO
HOURS G.P.M.
❑ BAILED a PUMPED COMPRESSEb AIR
NG G❑ RO
NO
YIELD
TEST
YIELD (G.P.M.)
WATER
LEVEL
MEASURE FROM LAND SURFACE — STATIC (Specify leet)
L�
DURING YIELD TEST fleet) 1
�e�
Depth of Completed Well
in feet below Land surface:
SCREEN "
MAKE
LENGTH OPEN TO AQUIFER (lest)
DETAILS
SLOT SIZE
DIAMETER (Inches)
IF GRAVEL
PACKED:
Diameter of well including
gravel pock (inches):
GRAVEL SIZE (Inches) FROM (foot) TO (feet)
DEPTH FROM LAND SURFACEI
FORMATION DESCRIPTION
Sketch exact location of well with distances, to of least
two permanent landmarks.
FEET to U.
a
/ f g-IP12,
If yield was tested of different depths during drilling, list below
FEET
GALLONS PER MINUTE
)ATE WE COMP TED
DATE I RE _O ]WELL
/7
DRILLER (Signature) �ja� �" ""� W L��j:/V u
I ,
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I;
ANTHONY J. NICODEMO Town of Patterson
Owner or Purc aser of Building Municipality
Nicodemo 55
Building Constructed by Section
_ Fairville Road, Putnam Lake, Patterson 5
Location - Street Block
1 family residence 3
Building Type Lot
GUARANTY OF SEPARATE SEWAGE- SYSTEM
I represent that I am wholly and completely responsible for the
location, workmanship, material, construction and drainage of the sewage
disposal system serving the above described property, and that it has been
constructed as shown on the approved plan or approved amendment thereto,
and in accordance with the standards, rules and regulations of the Putnam
County Department of Health, and hereby guaranty "to the owner, his succes-
sors, heirs or assigns, to place in good operating condition any part of
said system constructed by me which fails to operate for a period of two
years immediately following the date of initial use of the sewage disposal
system, or any repairs made by me to such system, except where the failure
to operate properly is caused by the willful or negligent act of the occu-
pant of the building utilizing the system.
The undersigned further agrees to accept as conclusive the de-
termination of the Director of the Division of Environmental Health Ser-
vices..of the Put -nam County. Department of Health as to whether or not the
failure of the system to operate was caused by the willful or negligent
act of the occupant of the building utilizing the system.
Dated this 29_ day of Jan, 19L Signature . ?AZ/� w -✓. , r zi0 %%�d =f
Title "
If corporation, give name
and address)
THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE
CERTIFICATE OF COMPLETION WILL BE ISSUED.
GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM.
Division of Environmental Health Services, Putnam County Department of Health
I I
k t -
1 iy E
UNT. DEPART�4iENT OF HEALTH
PUTNAMF CO
t
D /v�s�on .:of, Environmental Health Services, Camel, N Y. 10512 ,
- CONSTRUCTION PERMIT _. FOA SEWAGE, DISPOSAL °SYSTEM Town of Patterson
s Town or Ilage
' Fa i rvl.l'1 a Road; Fu "team Lake
_Located at Section _ Block
'Subdivision Putnam Lake - Lot 3 Job'
'F nthon J. N.icodemo,. `formerly °J. Guar.do =',A dressR:FD 1 North Salem, N.Y.
Owner y', d
w.,
Building Type 1 family re5 . ,Lot Area 10 , 000 $ f 4 0
Number of Bedrooms two Total,Ha6itable Space 76$ Square Feet'
_
';Separate Sew.eragea$Ystem to consist of 0. Gal `Septic Tank 1 54` tinsel feet X 3 width french
To begconstructed by Frank Amendola Address. Put:nam`.Lake; New York
.,
"Water SUPPIY Public. SUPPIY
a -
�, Ma.lanchuck Wand ,Co..; Route 22 Brewster; N.Y.
Private Supply to, be tlrilled by
Address
T g feet of rat 'abelF f I 1 l= to b`:e i n to 1 1 ed °`as per d raw i ngs o
"Other ,Requirements
A 4��
TM I I represent thaYl a h wholly and compiete� espy tl% n antl location ,of the proposed systems) 1) that the separate sewage disposal system
above described will be constructed as sh r yt,��,o €rjM appro . r ent there to antl in accordance with the standards rules an regulations o e Putnam
County;, Department ofy Health,. and f y;0r eo iefititi° the �� rtif cote, of- Constr coon _Compliance ";aatisfactory'to the Commissioner of Health•will .
be •submitted to the Department, anS a• jritt�fl gua, fitdA w be rnis'hed thee' his suete rs; heirs or assigns by wilder, that said builder will
place i' good operating condition an �a t Sa1�r o system d e.per.io two (2) earsimme ely f flowing_ thedate of the issu-
ance,.of the approval. of theCertrflcate; of C SteMCI, ' of =the stem ny repair heretoi2) hat drilled well described above
. /I
will be 1located as shown on the approveid pi n•.a I wi l b sta ed rdanc if -the dards, rule an a ons of . the 'Putnam
° ,C6unfy.Department`of
Date 1.5 J a nu a r 19 7 W, P.E. �R,A.
Address v1v .lei Z KafiQ' York License No. 81 29
APPROVED FOR CONSTRUCTION `Tfls, app , one.year from -the- daterissue ess ruction of the' building has been undertaken and Is,
,.revocable -for .cause or. may be amended ='or modified dejoiclnwiq _ es y by .:t issi a o_ +„�° hhaop ^s alteration of constru any—
..requires a new permit. < Appr ved for osal of domestic Se !tar ge, a or only
Date y`'~ 8 ,:Title .
p
M,
0
PUTNAM COUTTTY DEPARTMENT OF JfALTli
D:IVTSION OF T,P VtRONIZNTAL` HEALTH. SERVICES
COUNTY 01i'FTC10 P)TJTLDIIVG, CARMEL, N. Y. 10512
DEtiSIGN DATA 1T1 ?I,`I'- 01j,'AIZI�7'T SEWAGE DISPOSAL SYSTEM FILL; NO.
Whorl A. J. Nicodemo /formerlYAddress RFD 1; Croton Falls, New York
Josep Guarico - -�
hocaLtod at Fa i ry i 1 1 e Road Sec. 55 Block 6 T,ot 3
� neaTest, cross street
Mur r1,r'1 R0 :1 ty� Town of Patterson Waterished -_N.Y.C.
,,OH, 1'1,_11,C01 All, I oN `I'I?;_`f' DATA Rl,;QUIRED TO BI,, SUIiM f'I "I'l _i7 W111111 All'] ,TCA'I'l ON_,
10.;_16
36
18
�y
IVunil�� -:r C],OCK 11 "11`41;
4 10: 20
PERCOLATION
J`
PEF,t00T-,ATTON
(pse
Eep
o a er
a .er vc..
—
No. `1':i rru-;
From Ground Surface
in Tncl ieS
So.-I.I. Pate '
Uar )p Min.
Start
Stop
F..
Min./in drop
Inches
Inches
lrlclic..
PUTNAM COUTTTY DEPARTMENT OF JfALTli
D:IVTSION OF T,P VtRONIZNTAL` HEALTH. SERVICES
COUNTY 01i'FTC10 P)TJTLDIIVG, CARMEL, N. Y. 10512
DEtiSIGN DATA 1T1 ?I,`I'- 01j,'AIZI�7'T SEWAGE DISPOSAL SYSTEM FILL; NO.
Whorl A. J. Nicodemo /formerlYAddress RFD 1; Croton Falls, New York
Josep Guarico - -�
hocaLtod at Fa i ry i 1 1 e Road Sec. 55 Block 6 T,ot 3
� neaTest, cross street
Mur r1,r'1 R0 :1 ty� Town of Patterson Waterished -_N.Y.C.
,,OH, 1'1,_11,C01 All, I oN `I'I?;_`f' DATA Rl,;QUIRED TO BI,, SUIiM f'I "I'l _i7 W111111 All'] ,TCA'I'l ON_,
X23_9_16 33 1.8 21 3 33/3 =11 _
X110:00.10:36 36 18 21 3 36/3 =12
� 10:40 11 :16- ..... -.3 .__._....- 18 21 3 36/3 =12 _
.3 - 1_8_.9_ _02 27 1:8 21 3 _ 27/3 =9
9:05 9:35 30 18 21 3 30/3 =10
�5 9:40
10.;_16
36
18
211 3
IVunil�� -:r C],OCK 11 "11`41;
4 10: 20
PERCOLATION
36
PEF,t00T-,ATTON
(pse
Eep
o a er
a .er vc..
—
No. `1':i rru-;
From Ground Surface
in Tncl ieS
So.-I.I. Pate '
Uar )p Min.
Start
Stop
]drop • 1 n
Min./in drop
Inches
Inches
lrlclic..
1—_I 8:30 8:48 18
18
21
3
18/3 =6
_ ..'......8_.:_L- 9..`20 30
18
21
3
_ 30/3 =10 -
X23_9_16 33 1.8 21 3 33/3 =11 _
X110:00.10:36 36 18 21 3 36/3 =12
� 10:40 11 :16- ..... -.3 .__._....- 18 21 3 36/3 =12 _
.3 - 1_8_.9_ _02 27 1:8 21 3 _ 27/3 =9
9:05 9:35 30 18 21 3 30/3 =10
�5 9:40
10.;_16
36
18
211 3
36/.3 =12
4 10: 20
11-_56
36
18.
21 3
36/3 =12
511:00
11:36
.36
18
21 3
36/3 =12
?-
r)
�I
r�
Notrin: 1) '1e -its t.o -hn repeated at same depth until. a.pp )rox:imatel cgiial sd:il
r -al,00 t:r•T-r r,t,i,r�(.n�:cl r0, cach percolation test ho -le. M daL,U l,c) c: s11111n.l.ttc(l
I,rr?r ru'v:1ow.
P) to be made from top of hole.
_..TEST I'TT nAT/1_REQUIRED TO: .BE SU13MITTED.WTTH,A)?PUCnTION
DESCRTI" I'ION -'OF SOILS ENCOUNTERED IN '.PEST HOLES
DE'PTII
II0T2,
G. L.
Top soil
Topsoil & loam
3611
Sand, one
12!'
sml amts, clay -
II
H07 1V0. 2
Top soil
Topso i 1. ,& 1 oam
Sand, stone -
sml amts. clay
I I
HOLE No. 3
Top soil
Topsoil & Loam
sml amts, clay
II
24II II
II
II
30"
3611
II
,I
4211
II
`181'
II
54-11
I I
6011
I I
' 66"
II
7211
.17811
8411
II
• 11
.[NDTCATP ... =,L -AT iVTfilCli 'GROUND 'WATER IS ENCOUNTERED 42
.. ...., _ _
INDICATE LEVEE `TO WI-uC11 WATER LEVEL RISES AFTER BEING ENCOUNT JRED 11
TESTS MADE BY Theodore L.
Strauss Date
January
DESIGN
'Soil Rate Used 11 -15 Mi]V1 "Drop:
S.D. Usable Area
Provided 5,000 sf
No. of Bodrooms' 2 Septic
Tank Capacity 750 Gals.
Type Masonry
Absorption Area -Provided By 154
L. F. x24"
— _
width Trencli.
three feet of run of bank gravel f'�•i;,.��i..rt,o
they
aw'
Nam(._—Theodore L. Strauss
�Y� ..,!s AAIeuin .:
a
Add T,ess Deer Park Plaza
Katona , New Yor
TITTS SPACE, FOR USE 13Y HEALTH DE�ARTPT�l
THty[ %i�
Soil. Rate Approved Sq.
Ft /Ca.l . - v d by
Date
... f
_AJ
17i.,buse. plans 0.1K.
Dz,,s-'1_gn
Pores nresoaked'?
30" p;.rc test dept'Ll
onst. :results '
o r 3 rigs_
TI.Ole 'I oc-
CD 0. K.
Cu.0porate Affidavit.for. th
oer. than individual
Aut,hori'zatlion for ongineer
. al i cable.
f�,tter f'ro-rin, Water Su-i ply paro
L p
J''Joetsl Std.
Y 0
If variance requested- -such noted on pi.,M8 apps._
RETAILS
if change is proposed,
P.,�,J.stjng coint-ours shown if
new con.-t.ours)
Slopes for driv.ei(ay cuts, etc. shown )'orij, g
L"Etter s.-Pljice line location
Footing_d.rain., etc. location'
k
Top slope, bo*l,JU-oi-!i slope of fill X P_ C'
J.. -ests and deep test pit location
Porco L.tion 55 4ove,
,at
S
tic tank size and conformance to std.
3 B.R., house riiinimum
Efouse'set'.Mck shoi-71-1
t
T
x
Plan a-nd prof In S_L)L
All other vells and 105 closer 2'00
,shov,,n. or re-IL"orence made
?' z
P ope
P rty boz�ndarlleb mete.'6 and bbuhddlblear) Ly shbzin)j' i
SEPAPATION, D1Sr[*A.N'C_'E'S SPECIFIC ON PIAN
101
to
P. L,
I
201
to
Found7a�Ton walls ---i X
001
to
Nearest well
_S1
50 t
to
stream* ' march, lake, etc —. (_j: n c --i . e Tr_ 7an 06 n y
.15'
101
to
to
Curtain drain
water. line (P;
C-_vXfOLj ri rli
15'
to
storm drain
101
to
large trees
*101
from foundation to septic tank
151
to
pip_- from leader drain & f _5L:;_n�;
c. n4 an �r e r-,,- kc,�
i"' P
IJ
+0
I eN
i
1�Xtc; ._ 1. /_ �L'_.L
Insp . by :_.-� -�- _
TI`1:1:TIATY -SITS INSP)_'C`j''1
h
Pro; : r. y link:. .rs: or, coriners .found
Qa�i cis i, i_;r�a t : hour�e l.oca;�t ion ... .'
Vii] driv�ei;�a.y ri E;e3 cut
. .'
MTU'st trees be reir,ovod -note these
1s deelp•.hole reprEsemativa of ent:i.r.e •SDS area
A- d.dj`fi;J_ona.l ' dc,en holes n'eeded:
Sufficient SUS area available conSiderinry
driveti-ray cut, house Location, :separ. ation
distances, etc.
Slop: of tiTe line- wna..tr. en.ch accept able
Room allowed for expansion trenches _
Over 50 't. from s�;a,�x�, watercourse
Natural soil -not. stripped or SDS area
- . • . unr�Ycess?xll�z.:- �;ra.de- d....,... ,. - ..- - -.- ...., ...,...,.,.•,..;. ,....; _ ....�`+__.
10. 't . maintained f ror, prop. line and
20 ft. from house _
Separation of trench from house, well
etc. follows plan..
Number of bedrocns- checks ,
Stones, brush, stumps, rubble, etc. greater.
tI!,' 15 ft. from nearest trench
15 Ft. of heral soil horizontally from - --
trench
Junction boxes properly set i
Could surface run off from drivmmy, roads,
ground surface, etc. channel near SDS .
area . . . . . . .... . --
Does lot car. a.ina.re annea r O.K. in area of 5DS
FINAL GRADING OF SITE ACCEPTABLE
I
In the' Matter 'of the Application for a
variance of Putnam County Health Department
1 `5�
ireguletions by
E
• ANTHONY J. NICODEMO
I
IIANTHONY J. NICDDEMD, contract vendee of Lots Noe. 7388,1389, 7391, 7398
at Putnam Lake in the Town of Patterson, Putnam County, Now York# being a
(part of premises conveyed to Bose Guardo by dead dated the 2nd day of
(February, 1954 and recorded in the office of.the Clerk of the County of Putnam
11in Libor 441 of conveyances at page 178, and .being part of Lot 3, Block 6,
(I Section 55 on the tax map of the Town of Patterson;
hereby requests that the Putnam County Health department grant to the
�iappliaant a variance from the County Health Department regulations restricting i
the distance that, a sawage 'system must be from a-well.
This application is made because the said ANTHONY.J. NICODEMO has applied
�to the building department of the Town of Patterson for a build
:.ing permit and
is had a eite.and septic plan prepared for the approval of the County Health
�iDepartment by Theodore Lawrence Strauss,'_Aegistered Architect; and the purpose
. ... roc
IlOf this .application . ie to place in permanent record the fact that such a
Ivariance. has..been . requested
I1,Dsted :February 5;.;•1975
II ANTHONY'J. NIODDEMD
l
;State of New York
i unty of Westchester as i
On this 5th day of February, 1975 before me came Anthony J. Nicodemo,
'known to me and known to be'the person who executed the above instrument and
Ipnd acknowledged to m6 that he executed the same as his free act and deed...
FRANK N. BECK B:CR�IRII
• �joi0ry Nuhhc, mot"'- 0f Ncw
Nu, 0^ 16:330
.:.... �,ju.ilified 'r4'c•.t.ha;.„ n..r...,,
le iie Ma: rl, ' }tl. 1
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APPROVED
DS
7
MAY 22194f'
AFT
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rl �� .`J ' DY �1F DIVISION
ju
'70, 001 13 'ly•a,l oe•vvn55
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